NCP Bernal Imbalanced Nutrition pt2

A 29-year-old woman was diagnosed with Anorexia nervosa, she is conscious and responded to
the questions but has a slight confusion when responding and moves when pain was localized a
GCS result of 12, she was assessed and seen by Dr. Jean, the patient exercises every morning,
restricts eating and eats once a day sometimes other days she takes no food at all. Vital signs
show the patient is bradycardic with a heart rate of 70 bpm, has hypotension with a blood
pressure of 75/50mmHg, respiratory rate of 12 bpm and a temperature of 34.8°C. She passes
stool after every 3 days, brittle nails, brittle and less hair. She has amenorrhea for 3 months.
She says she put herself on a restrictive diet for 3 months and verbalized "Tan-aw nako sa
akong kaugalingon kay tambok nako". Her BMI (body mass index) resulted to 17.5.
Nursing diagnosis:
 Imbalanced nutrition: less than body requirements related to insufficient dietary intake as
evidenced by food intake less than recommended daily allowance, excessive hair loss
and a BMI of 17.5
Rationale: Imbalanced nutrition: less than body requirements is defined by Nanda as an intake
of nutrients insufficient to meet metabolic needs. To work properly and perform the tasks of
everyday life, your body needs a variety and specific quantities of nutrients. There are several
cases where adequacy in a person's dietary requirements is not met. It can lead to poor
nutrition if your body doesn't get those nutrients, which is normal when consuming an
unbalanced diet.
Branch, S. (n.d). The effects of not eating a balanced diet. Retrieved from
https://www.livestrong.com/article/247666-the-effects-of-not-eating-a-balanced-diet/
Patient outcome:
 After 8 hours of nursing intervention, patient will understand the importance of taking an
adequate amount of nutrition aeb:
a. Verbalization of at least one of the health teachings mentioned
b. Consume adequate nourishment: at least 2000 calories a day
c. Exhibit no further weight loss
Interventions:
1. Assess patient’s ability to obtain and use essential nutrients.
R: Several factors may affect the patient’s nutritional intake, so it is necessary to assess
accurately. Cases of vitamin D deficiency rickets have been reported among dark-skinned
infants and toddlers who were exclusively breast fed and were not given supplemental vitamin
D.
2. Take a nutritional history with the participation of significant others.
R: Family members may provide more accurate details on the patient’s eating habits, especially
if patient has altered perception.
3. Establish a minimum weight goal and daily nutritional/ metabolic requirements.
R: Provides comparative baseline for effectiveness of therapy. Note: Malnutrition is a mood-
altering condition, leading to depression and affecting cognitive function and decision making.
Improved nutritional status enhances thinking ability, allowing initiation of psychological work
4. Provide a pleasant environment.
R: A pleasing atmosphere helps in decreasing stress and is more favorable to eating.

5. Maintain a regular weighing schedule, such as Monday and Friday before breakfast in
same attire, and graph results
R: Provides accurate ongoing record of weight loss or gain. Also diminishes obsessing about
changes in weight.
6. Instruct patient to have small, frequent feedings
R: It will enhance the appetite and will have better digestion of food intake
7. Discourage patient in drinking caffeinated or carbonated beverages.
R: it will let the patient decrease his/her hunger.
8. Administer enteral or parenteral nutrition, as appropriate.
R: TPN, or hyperalimentation, may be required for life-threatening situations; however, enteral
feedings are preferred because they preserve GI function and reduce atrophy of the gut.
9. Consider six small nutrient-dense meals instead of three larger meals daily to lessen the
feeling of fullness.
R: Eating small, frequent meals lessens the feeling of fullness and decreases the stimulus to
vomit.
10. Offer high protein supplements based on individual needs and capabilities.
R: Such supplements can be used to increase calories and protein without conflict with
voluntary food intake.
11. Explain to the patient and significant others the importance of maintaining proper
nutrition
R: It will give a better understanding on the need of meeting the daily nutritional requirements of
the body.
12. Encourage family members to bring food from home to the hospital.
R: Patients with specific ethnic or religious preferences or restrictions may not consider foods
from the hospital.
13. Once discharged, help the patient and family identify area to change that will make the
greatest contribution to improved nutrition.
R: Change is difficult. Multiple changes may be overwhelming.
Wayne, G. (2017). Imbalanced Nutrition: Less Than Body Requirements Nursing Care Plan.
Retrieved from https://nurseslabs.com/imbalanced-nutrition-less-body-requirements/

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A 29-year-old woman was diagnosed with Anorexia nervosa, she is conscious and responded to

2. Take a nutritional history with the participation of significant others.

R: A pleasing atmosphere helps in decreasing stress and is more favorable to eating.

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